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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320074
Report Date: 03/22/2022
Date Signed: 03/22/2022 04:46:59 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/16/2021 and conducted by Evaluator Stephanie Cifuentes
COMPLAINT CONTROL NUMBER: 11-AS-20211116124037
FACILITY NAME:CLEARVIEW TREATMENT PROGRAMSFACILITY NUMBER:
198320074
ADMINISTRATOR:GHERNA, ELIZABETHFACILITY TYPE:
772
ADDRESS:2616 GRANDVIEW AVENUETELEPHONE:
(310) 344-5134
CITY:VENICESTATE: CAZIP CODE:
90291
CAPACITY:6CENSUS: 4DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
12:29 PM
MET WITH:Emily Osbourne-QATIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Facility is understaffed.
Facility grounds are not maintained.
Facility staff are not adequately trained.
Errors in medication administration are being made.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced subsequent complaint investigation at above facility. LPA spoke to Program Director Stephen Rudoy, who stated facility has no covid-19 cases and there are no signs or symptoms. LPA Cifuentes arrived at the facility and was greeted by staff Emily Osbourne. LPA explained purpose of visit was to deliver findings for the allegations listed above and was allowed entry to the facility.

The investigation consisted of the following: On 11/23/2021 LPA conducted initial 10 day visit, met with Director Steven Rudoy and completed a walkthrough of facility. On 12/15/2021 LPA interviewed client 1 – client 3 (C1-C3), Staff 1-Staff 5 (S1-S5). LPA reviewed and requested copies of the staff schedule and other documents in association with the allegations.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 11-AS-20211116124037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAMS
FACILITY NUMBER: 198320074
VISIT DATE: 03/22/2022
NARRATIVE
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Allegation: Facility does not have a certified Administrator.
It is alleged that facility administrator Elizabeth Gherna is out of state and not actively working as facility administrator. LPA spoke to Steven Rudoy, Executive Director of Clearview Treatment Programs, who stated Liz Gherna was the Administrator, but that she had been moved to other duties, so they had instated Jasmine Lucas as administrator. Ms. Gherna’s administrator license expired on August 31, 2021. Per Dr. Rudoy, Ms. Lucas was taking the classes to satisfy the requirements for a certified administrator and had submitted the documentation to CCLD. Per Community Care Licensing Administrator Certification unit, packet was received for Jasmine Lucas on 10/8/2021. LPA was notified on 11/16/2021 that Ms. Lucas would no longer be administrator and that Leilani Le would be taking the classes to become a certified administrator. As of 3/22/2022 LPA Cifuentes was able to confirm that the administrator certification section has received an administrator packet for Leilani Le but are behind on processing it. LPA was unable to confirm when the payment for the certification was cashed or if there have been any other delays in processing due to the holidays or Covid-19 pandemic. LPA interviewed staff 1-staff 7 regarding allegations. When asked if the facility had an administrator, three named the past administrator Liz Gherna, one named Jasmine, two were unsure and one named the house administrator. LPA spoke to clients 1-client 3 regarding allegation, one named a house administrator and the other two were unaware an administrator was needed.
Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

Allegation: Facility is understaffed.
Complainant alleges that staffing ratios are below requirements, causing quality of care concerns with clients amongst other issues. LPA reviewed facilities program plan, which does not give a specific ratio of staff to residents, it does however discuss the continuous monitoring and supervision of clients. LPA Cifuentes spoke to Emily Osbourne regarding the ratio of staff to residents. Per Ms. Osbourne, there is no set ratio, the amount of staff needed is based on client’s acuity but that she felt there were enough staff to see to the needs of the clients in care. LPA reviewed the staff schedule for November 1 to November 14, which showed two staff on the AM and PM shifts and one staff overnight. When LPA was touring facility, two staff were present, one of which was the house manager. LPA asked facility clients if they believed the facility had enough staff. Three out of three stated they believed there were enough staff during the week and two stated they believed there were enough program aides on the weekends. LPA Cifuentes spoke with facility staff and of the five questioned, three stated there where days they felt they were short of staff.
Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

Continued on 9099-C
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 11-AS-20211116124037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAMS
FACILITY NUMBER: 198320074
VISIT DATE: 03/22/2022
NARRATIVE
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Allegation: Facility grounds are not maintained.
Complainant alleges that facility is not meeting required grounds and maintenance codes causing a host of safety issues and concerns. LPA Cifuentes toured facility grounds on 11/23/2021. House appeared clean, indoor and outdoor passageways were free of obstructions, lights all operated properly as did sinks and toilets and beds had all required linens. During inspection handle broke on toilet in bedroom 4, but it was immediately repaired by staff.
LPA spoke with clients regarding the allegation. Out of the three interviewed, all three residents stated they believed the facility grounds were maintained well and that the facility was in good repair. LPA interviewed staff regarding the allegation. Of those interviewed, 5 out of 5 staff stated that facility grounds are in good repair and well maintained. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

Allegation: Errors in medication administration are being made.
Complainant alleges that there are errors in medication administration being made by the facility. LPA Cifuentes reviewed medication administration log for residents and found no inconsistencies. LPA spoke with clients regarding the allegation. Out of the three interviewed, all three residents stated their medications are being given timely and correctly. LPA interviewed staff regarding the allegation. Of those interviewed, 5 out of 5 staff stated that medications are given timely and correctly. Based on information gathered, the Department did not find sufficient evidence to support the allegation mentioned above.

The Department’s investigation consisted of an inspection of the facility, observation, analysis of residents records, incident report, and interviews conducted and found no evidence to support the allegations: “Facility does not have a certified Administrator”, “Facility is understaffed,” “Facility grounds are not maintained “Errors in medication administration are being made.”, Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview conducted, and a copy of the report was given to Emily Osbourne, Quality Compliance Coordinator.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/16/2021 and conducted by Evaluator Stephanie Cifuentes
COMPLAINT CONTROL NUMBER: 11-AS-20211116124037

FACILITY NAME:CLEARVIEW TREATMENT PROGRAMSFACILITY NUMBER:
198320074
ADMINISTRATOR:GHERNA, ELIZABETHFACILITY TYPE:
772
ADDRESS:2616 GRANDVIEW AVENUETELEPHONE:
(310) 344-5134
CITY:VENICESTATE: CAZIP CODE:
90291
CAPACITY:6CENSUS: 4DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
12:29 PM
MET WITH:Emily Osbourne-QATIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
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8
9
Facility staff are not adequately trained.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced subsequent complaint investigation at above facility. LPA spoke to Program Director Stephen Rudoy, who stated facility has no covid-19 cases and there are no signs or symptoms. LPA Cifuentes arrived at the facility and was greeted by staff Emily Osbourne. LPA explained purpose of visit was to deliver findings for the allegations listed above and was allowed entry to the facility.

The investigation consisted of the following: On 11/23/2021 LPA conducted initial 10 day visit, met with Director Steven Rudoy and completed a walkthrough of facility. On 12/15/2021 LPA interviewed client 1 – client 3 (C1-C3), Staff 1-Staff 5 (S1-S5). LPA reviewed and requested copies of the staff schedule and other documents in association with the allegations.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 11-AS-20211116124037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754
FACILITY NAME: CLEARVIEW TREATMENT PROGRAMS
FACILITY NUMBER: 198320074
VISIT DATE: 03/22/2022
NARRATIVE
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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Facility staff are not adequately trained.
Complainant alleges that staff training in general and particularly in medication administration and CPR training is not up to standard. LPA Cifuentes reviewed facility records and found current CPR certifications for facility staff. LPA reviewed medication training, which was conducted by facilities Quality Compliance officer Emily Osborne and not a licensed professional. Per Emily Osborne, facility has a nurse who currently completes medication training. Registered Nurse Olayinka Oluyibi started with the program in September. LPA spoke with clients regarding staff training. All three clients interviewed stated they believed most of the staff was well trained. LPA interviewed staff regarding allegation. Four of those questioned did not know anything about staff training and two stated that they received training in the kitchen or food handlers’ certificate. Based on information gathered, the Department did find sufficient evidence to support the allegation mentioned above

California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of the LIC 9099 and appeal rights forms were provided to Compliance Coordinator Emily Osbourne.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 11-AS-20211116124037
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTERY PARK, CA 91754

FACILITY NAME: CLEARVIEW TREATMENT PROGRAMS
FACILITY NUMBER: 198320074
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/05/2022
Section Cited
CCR
81075(b)(1)(A)
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HEALTH-RELATED SERVICES
The licensee shall ensure that each client receives necessary first aid and other needed medical...services, including...Facility staff must receive training from a licensed professional.
This requirement is not met as evidenced by:
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Licensee will insure licensed proffesional completes medication trainig for all facility staff. Copy of course outline and sign in sheet will be faxed to LPA Cifuentes by POC due date.
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On 11/19/2021 LPA Cifuentes noted during an interview, that medication trainiing was conducted by Compliance Officer not a licensed proffesional. This is a potential risk to the health of the clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Stephanie Cifuentes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6